ARN Health Policy Digest - September 2023

We are pleased to present the September issue of the ARN Health Policy Digest. This member benefit provides updates on health policy and legislative and regulatory developments that may be of interest to rehabilitation nurses. 

Government Shutdown Looms

As we approach the end of the fiscal year, the status of FY 2024 funding remains uncertain, and there's a growing likelihood of a government shutdown if Congress cannot approve a continuing resolution (CR) before September 30.

In the Senate, members voted overwhelmingly to advance a bipartisan CR that would keep the government open until November 17. The bill includes more than $6 billion in Ukraine funding and more than $6 billion in disaster relief. The bill does not include border security money or spending cuts that House conservatives have been demanding. The Senate could vote on final passage of the CR as late as Sunday, October 1, which is after government funding expires. It is unclear whether the bill will pass as it could lose the support of some GOP senators who do not want Ukraine aid included in the package.

If the Senate does pass a bipartisan stopgap bill and sends it to the House, its fate does not look good. Some of the most conservative members in the House are urging House Speaker Kevin McCarthy (R-CA) to oppose a CR, or make sure any CR includes spending cuts and conservative policy riders, like border security. This political divide points to a shutdown happening. We look forward to keeping ARN members updated on the funding situation in next month's digest.

Legislation Introduced to Support Nursing Workforce

Senate Health, Education, Labor, and Pension (HELP) Committee Chair Bernie Sanders (I-VT) and Senator Roger Marshall (R-KS) introduced legislation to address the primary care crisis and the major shortages of nurses, primary care doctors, and other health care providers across the country. Specifically, the legislation:

• Provides $240 million per year through FY 2028 through a one-time mandatory supplemental, totaling $1.2 billion for not-for-profit community colleges and state universities to increase the number of students enrolled in accredited, two-year registered nursing programs.
• Provides $28.5 million in annual discretionary appropriations in FY 2024 through FY 2026, as well as $28.5 million per year for three years through a one-time mandatory supplemental to support approximately 1,000 new nurse faculty entering the workforce each year.
• Authorizes a demonstration program with $15 million in annual discretionary appropriations in FY 2024 and FY 2025, for grants to nursing schools to close the salary gap between nursing faculty and nurse clinicians.
• Reauthorizes the NURSE Corps Scholarship and Loan Repayment program through FY 2026 and increases discretionary funding levels from $93 million in FY 2023 to $93.6 million in FY 2024, $94.6 million in FY 2025 and $95.6 million in FY 2026.
• Provides funding for Primary Care Nurse Practitioner Training Programs at $30 million per year from FY 2024 through FY 2026 for 30 one-time awards per year of $1 million per health center. Each award would allow a health center to train four nurse practitioners, resulting in over 350 more primary care nurse practitioners specifically trained for a career caring for underserved populations.

While the legislation has been met with criticism from some republican senators, including HELP Committee Ranking Member Bill Cassidy (R-LA), due to concerns about increases in spending without a plan to pay for it, the bill managed to pass the HELP Committee on September 21 with bipartisan support by a vote of 14-7. The bill text and section-by-section are available for review.

ARN Comments on CMS' CY 2024 MPFS and OPPS Proposed Rules

 ARN recently provided comments on two proposed rules released by the Centers for Medicare & Medicaid Services (CMS) – the CY 2024 Medicare Physician Fee Schedule (MPFS) and the CY 2024 Hospital Outpatient Prospective Payment System (OPPS). ARN's comments on the MPFS proposed rule focused on supporting payment for caregiver training services and payment for new services to account for resources when clinicians involve community health workers, care navigators, and peer support specialists in furnishing medically necessary care. Additionally, ARN's comments on the OPPS proposed rule focused on supporting CMS' proposal to allow cardiac rehabilitation, intensive cardiac rehabilitation and pulmonary rehabilitation services to be provided under the supervision of a physician assistant, nurse practitioner, or clinical nurse specialist, beginning January 1, 2024. ARN appreciates the opportunity to provide these comments and looks forward to reviewing the MPFS and OPPS final rules when they are released later this Fall.

NIH Designates People with Disabilities as a Population with Health Disparities

Director of the National Institute on Minority Health and Health Disparities (NIMHD), Dr. Eliseo Pérez-Stable, announced the designation of people with disabilities as a population with health disparities for research supported by the National Institutes of Health. The decision, made in consultation with the director of the Agency for Healthcare Research and Quality, Dr. Robert Otto Valdez, is a direct result of an NIMHD advisory council report, a review of the science and evidence, and input from the disability community. The DRRC, of which ARN is a member, has continuously advocated for this. Therefore, this decision is a big win for the disability community!

The announcement also comes with a notice of funding opportunity calling for research applications focused on novel and innovative approaches and interventions that address the intersecting impact of disability, race and ethnicity, and socioeconomic status on healthcare access and health outcomes. The earliest submission date for applicants is January 05, 2024.

Notice of Funding Opportunities

​Below is a list of other funding opportunities for interested ARN members.

• Understanding and Mitigating Health Disparities experienced by People with Disabilities caused by Ableism (R01 Clinical Trial Optional) (RFA-HD-24-007) Application Receipt Date(s): November 29, 2023

• Notice of Special Interest (NOSI): Availability of Administrative Supplements for BRAIN Initiative Recipients to Support Resource Dissemination (NOT-EB-23-010)
• Ruth L. Kirschstein National Research Service Award (NRSA) Individual Fellowship for Students at Institutions with NIH-Funded Institutional Predoctoral Dual-Degree Training Programs (Parent F30) (PA-23-260)
• Ruth L. Kirschstein National Research Service Award (NRSA) Individual Predoctoral Fellowship (Parent F31) (PA-23-272)
• HEAL Initiative: HEAL KIDS (Knowledge, Innovation and Discovery Studies) Pain: Acute Pain Clinical Trials Program (U01 Clinical Trial Required) (RFA-HD-24-011) Application Receipt Date(s): November 20, 2023
• HEAL Initiative: HEAL KIDS (Knowledge, Innovation and Discovery Studies) Pain Program Resource and Data Center (U24 Clinical Trial Not Allowed) (RFA-HD-24-012) Application Receipt Date(s): November 20, 2023

• Request for Information (RFI): Inviting Comments and Suggestions on Updating the NIH Mission Statement (NOT-OD-23-163)

• NOT-OD-23-165: Notice of NIH Participation in the National Science Foundation Solicitation NSF 23-614: Smart Health and Biomedical Research in the Era of Artificial Intelligence and Advanced Data Science Full application submission deadlines are November 9, 2023; October 3, 2024; and October 3, 2025.