Medicare cuts reduced and telehealth flexibilities remain.

After intense negotiations, the new federal Omnibus spending package was signed tonight with some important features for palliative care. To start, the anticipated 4.5% cut in Medicare payment rates has been softened to 2% beginning January 1, 2023, and then a 3.5% cut in 2024. Many physician advocacy organizations are disappointed that a sizable cut is still present and can be expected to encourage Medicare physician payment reform legislation in 2023.

Additionally, this Omnibus package extends the Medicare telehealth payment rules through at least the end of 2024, giving some stability to programs incorporating telehealth visits. There are also many positive provisions to meet the country’s mental health and substance abuse needs. In particular, the requirement that a health care practitioner apply for a separate waiver to dispense certain narcotics (such as buprenorphine) has been eliminated, and in an unusual move, requires Medicare-certified providers to complete training in treating patients with a substance use disorder. Adding more relief and stability, the Child Health Insurance Program has been extended for another five years.

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