What the ‘cromnibus’ means for healthcare

A new year has begun, to be influenced by the $1.1 trillion spending bill approved by Congress and signed by President Barack Obama last month.

The 1,603-page continuing resolution and omnibus spending bill, dubbed the “cromnibus” by some but formally named the Consolidated and Further Continuing Appropriations Act, 2015, contains several provisions related to healthcare. Some of them:

• $30.3 billion for the National Institutes of Health, which includes the National Institute on Aging. This amount represents an increase of $150 million over the previous year. Alzheimer’s disease and brain research programs are expected to benefit.
• $3.6 billion for the management and operations of the Centers for Medicare & Medicaid Services (CMS), representing no increase in funding. The law asks CMS, in its budget request for fiscal year 2016, to suggest how provider documentation for face-to-face encounters can be simplified while still preventing home healthcare-related fraud, increasing access to home healthcare and lowering costs related to such care. The law also directs CMS to educate providers on claims processes to reduce the need for recovery audit contractor audits, which can affect access to care as well as provider financial stability.
• No new money for the Affordable Care Act (ACA), including ACA-related funding for CMS, but no reduction in funding.
• More than $6.9 billion for the Centers for Disease Control and Prevention, an increase of more than $42 million.
• Cromnibus language clarifies that confidentiality agreements do not preclude government contractors from reporting allegations of waste, fraud or abuse to the Occupational Safety and Health Administration and other agencies.
• About $60.4 million for the Office of the National Coordinator for Health Information Technology (ONC), representing neither an increase nor a decrease in funding. The ONC also is required to submit plans and reports detailing issues related to interoperability between electronic health records systems.
• $159.1 billion for the Department of Veterans Affairs, including funds to expand medical staff at facilities and the buildings themselves. The VA’s inspector general will receive a $5 million increase to help ensure that former members of the military receive adequate care.
• No fix to the sustainable growth rate formula for the reimbursement of physicians though Medicare, and no extension of a pay increase for primary care physicians who see Medicaid beneficiaries.

The spending bill should fund most of the federal government through September.

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