What a Way to End the Year in DC!

In its final governmental report of 2020, the research team at Wells Fargo reported to its institutional investor client base a generally upbeat assessment for 2021 as they reviewed the implications on medicine generally of President-elect Joe Biden’s healthcare team, COVID-19 relief, 2021 funding, and the updated Centers for Medicare & Medicaid Services (CMS) hospital outpatient and physician fee rules.

One bill that has not received much press attention, but will, nonetheless affect every orthopedic clinic and hospital is the No Surprises Act. This bipartisan, bicameral legislation took two years of legislative work to come into effect. It’s objective is to protect consumers from surprise medical bills and among its key features are provisions for cost-sharing transparency and arbitration to resolve payment disputes between insurers and providers. Neither insurers nor their employer customers are happy with the bill. Noted Wells Fargo’s research team, “An advocacy group representing insurers and employers blasted the proposal as a giveaway to private equity backed providers.”

In addition to Anthony Fauci, M.D., who will serve as President-elect Biden’s chief medical adviser, the incoming healthcare team will include Xavier Becerra, Vivek Murthy, M.D., Rochelle Walensky, M.D., MPH, Natalie Quillian, and Jeff Zients.

Of course, just under the deadline for Congress to recess for the year, the lawmakers passed a $900 billion COVID-19 relief bill—which President Trump threatened to pocket veto. The bill, which included vaccine development and distribution, increased unemployment benefits, a paycheck protection program, and state and local aid was ultimately signed five days before the year ended.

And, just to make the end of the year interesting, if not chaotic, the $1.4 trillion omnibus appropriations bill, which may include the aforementioned COVID-19 relief, was also approved by a veto-proof majority in Congress.

It is not all conflict on the Hill, as CMS finalized its hospital outpatient and physician fee rules, both going into effect on January 1, 2021. CMS issued a final rule updating the Medicare physician fee schedule. CMS also issued a final rule updating “payment policies and rates for services received at Medicare hospital outpatient departments and ambulatory surgical centers (ASCs).”