House Releases FY 22 Appropriations Schedule:
When Congress returns from the Fourth of July Holiday, the House Appropriations Committee will vote on their fiscal year (FY) 2022 spending bill.  The Labor-HHS Subcommittee is scheduled to meet on July 12, where the bill will most likely advance to a full committee vote on July 15.  The bill language is traditionally made public by the committee on the day of the vote. The timing on the Senate markup of the Labor-HHS spending bill is much further behind schedule.

On May 28, the White House released the fiscal year (FY) 2022 budget proposal to Congress. In particular, the State Offices of Rural Health grant program (SORH) was requested at the congressionally authorized level of $12,500,000 for FY 22, the same amount that Congress enacted for FY 21. NOSORH has asked Congress to increase funding to $15 million for FY 22. The White House request for the Rural Hospital Flexibility grant program (Flex) was $57,509,000, an increase of $1.9 million over the FY 21 congressionally enacted level.

Speaking of the Rural Hospital Flexibility grant program, NOSORH continued to work with House and Senate staff in June to introduce a bill re-authorizing the FLEX program. Stay tuned for more details next month.

Rural Health-Related Legislation Introduced In June
Rep. Terri Sewell (D-AL) introduced H.R.4066  which intends to preserve access to rural health care by ensuring fairness in Medicare hospital payments. The area wage index bill would establish a national minimum (0.85) for the Medicare Area Wage Index to ensure rural hospitals receive payment for services while preserving the existing reimbursements for urban hospitals.  Companion legislation was introduced in the U.S. Senate by Sens. Mark Warner (D-VA), John Cornyn (R-TX), Marsha Blackburn (R-TN), Rev. Raphael Warnock (D-GA), and Tim Kaine (D-VA).

Rep. Doris Matsui (D-CA) and Bill Johnson (R-CA) introduced the Telemental Healthcare Access Act, which seeks to amend title XVIII of the Social Security Act to remove the statutory requirement that Medicare beneficiaries be seen in person within six months of being treated for mental and behavioral health services through telehealth.

Rep. Liz Cheney (R-WY) introduced the Advancing Telehealth Beyond COVID-19 Act. The bill seeks to permanently remove the originating site and geographical limitations that were temporarily waived in the CARES Act. The bill would also make permanent the telehealth coverage at FQHCs and RHCs. H.R.4040 would also allow any physician who can currently bill for Medicare to be eligible for this waiver and will cover audio-only as a form of telemedicine.

Rep. Gus Bilirakis (R-FL) reintroduced the Enhance Access to Support Essential Behavioral Health Services (EASE) Act. Bill H.R.4036 seeks to expand access by permanently allowing Medicare and Medicaid to reimburse providers for all behavioral health services for children, seniors and those on disability. Senator John Kennedy (R-LA) introduced companion legislation in the Senate.

Rep. Ruiz (D-CA) introduced H.R.4014, the Cap Flex Act, which seeks to allow new teaching hospitals in rural or areas with a specialty shortage an additional five years to build out their residency program. The bill instructs HHS in determining which residency programs qualify, including whether an area lacks adequate resources, is experiencing a primary or specialty physician shortage, or does not have enough approved residency training programs. Here is the press release from Ruiz. A companion bill was introduced by Sens. Barrasso (R-WY) and Cortez-Masto (D-NV).

Rep. Newhouse (R-WA) introduced H.R.4008 which seeks to amend the Public Health Service Act to provide for the establishment of a virtual health pilot program within HRSA to facilitate utilization of remote patient monitoring technology to maintain or expand access to health care services for individuals in rural areas. Companion legislation was introduced in the Senate by John Kennedy (R-LA). Here is the Newhouse press release.

Rep. Brad Schneider (D-IL) introduced H.R.3541 to provide incentives to physicians to practice in rural and medically underserved communities. The reintroduced bill would extend and expand the Conrad 30 Waiver program, which allows foreign doctors studying in the U.S. to obtain a visa following medical residency if they practice in a rural or medically underserved area for at least three years. Under current law, foreign doctors on J-1 educational visas must return to their home country upon completing medical residency and wait two years before they can apply for a new visa or green card. A companion bill was introduced in the Senate by Sen. Amy Klobuchar (D-MN).