HJAR Mar/Apr 2023

HEALTHCARE JOURNAL OF ARKANSAS I  MAR / APR 2023 39 Joseph W. Thompson, MD, MPH President and Chief Executive Officer Arkansas Center for Health Improvement rule that requires Congress to offset costs in new legislation with spending cuts or revenue increases. The cut is now paused through the end of 2024. Workplace accommodations for mothers. The act requires employers to provide rea- sonable accommodations for medical con- ditions related to pregnancy and prohibits employers from refusing employment to workers needing such accommodations. It also requires employers to provide time and space — not a bathroom— for breastfeeding mothers to pump breast milk. Mental health. Provisions include funding for mobile mental health treatment sites, Medicare coverage for family and marriage counseling services, and a requirement that Medicaid programs offer searchable direc- tories of mental health service providers. Substance abuse treatment. The act seeks to increase access to substance abuse treat- ment by eliminating the so-called X-waiver requirement, which called for a provider to undergo additional training and submit an application to the Drug Enforcement Ad- ministration to prescribe buprenorphine, a drug used to treat opioid use disorder. Physician workforce. The act calls for the establishment of an additional 200 Medi- care-funded graduate medical education positions in 2026, with half of the positions dedicated to psychiatry and related subspe- cialty residencies. Ten percent of the posi- tions will be dedicated to rural hospitals, hospitals in health professional shortage areas, and hospitals in states with newmedi- cal schools. Policy Board of the Arkansas Center for Health Improvement. 3 If all goes well, by the time you read this, our legislators and Gov. Sarah Huckabee Sanders will have taken this simple step to support moms and infants in the state that has the highest maternal mortality rate and the third-highest infant mortality rate in the nation. 4,5 Health funding. The budget act provides $120.7 billion to the U.S. Department of Health and Human Services, a $10 billion increase from the previous year, and $9.2 billion to the Centers for Disease Control and Prevention, a $760million increase from the previous year. More than half of the CDC’s funding boost is dedicated to increasing pre- paredness for another pandemic. Telehealth flexibilities. Under the budget act, Medicare telehealth flexibilities that were set to expire five months after the end of the public health emergency will continue through the end of calendar year 2024. Ex- amples of these flexibilities include allowing telehealthcare delivery at any site at which a patient is present, including the patient’s home; continuing to allow federally quali- fied health centers and rural health clinics to provide telehealth services; and extending coverage of audio-only telehealth services. Softening of Medicare cuts. Medicare phy- sician reimbursement rates were set to de- crease by 4.5% in 2023 under the Medicare Physician Fee Schedule, but under the bud- get act, the rates instead will decrease by 2% in 2023 and by about 3% in 2024. The budget act also delays a 4% cut in Medicare payments to providers — about $38 billion — which was mandated by PAYGO, a budget Community health workers. The act autho- rizes $50 million annually for fiscal years 2023 through 2027 for community health workers. Why the heightened focus on healthcare in the omnibus package? The COVID-19 pandemic, with its far-reaching impacts on physical health, mental health, and sub- stance abuse, has attached a greater sense of urgency to healthcare than any event in a generation. Congress approved the pack- age before control of the House and Senate became split as a result of the 2022 midterm elections, but the bill passed with strong bi- partisan support, demonstrating that the health of the American people is a priority on both sides of the aisle. n REFERENCES 1 State of Arkansas 93rd General Assembly. To Promote Integrity In Welfare Programs; And To Amend The Medicaid Eligibility Verification Sys- tem 2021. Act 780. arkleg.state.ar.us/Acts/FTPD ocument?path=%2FACTS%2F2021R%2FPublic% 2F&file=780.pdf&ddBienniumSession=2021%2F 2021R 2 Kaiser Family Foundation. “Medicaid Postpartum Extension Tracker.” Accessed Jan. 30, 2023. kff. org/medicaid/issue-brief/medicaid-postpartum- coverage-extension-tracker 3 Arkansas Center for Health Improvement. For Maternal Health Awareness Day, ACHI highlights state’s rock-bottom ranking [Press release]. Jan. 23, 2023. achi.net/news-releases/for-maternal- health-awareness-day-achi-highlights-states- rock-bottom-ranking 4 Kaiser Family Foundation. “Maternal deaths and mortality rates per 100,000 live births: Time- frame: 2018-2020.” Accessed Jan. 30, 2023. kff. org/other/state-indicator/maternal-deaths-and- mortality-rates-per-100000-live-births/?curre ntTimeframe=0&selectedDistributions=matern al-mortality-rate-per-100000-live-births&sortM odel=%7B%22colId%22:%22Maternal%20Mortal- ity%20Rate%20per%20100,000%20live%20Birth s%22,%22sort%22:%22desc%22%7D 5 Centers for Disease Control and Prevention. “Infant Mortality Rates by State.” Accessed Jan. 30, 2023. cdc.gov/nchs/pressroom/sosmap/ infant_mortality_rates/infant_mortality.htm