Congress passed and the President signed the fiscal year (FY) 2021 omnibus spending bill, which included a COVID-19 stimulus package and health extenders. The massive 5,593-page bill (HR 133) funds federal agencies through September 30, 2021.
The 12 FY21 spending bills total $1.4 trillion, not including the nearly $900 billion to address COVID-19. The omnibus includes $197 billion in programmatic funding for the US Departments of Labor, Health and Human Services, Education, and Related Agencies, which is an increase of $2.8 billion over the FY20 level. In addition, many programs critical to osteopathic medical education (OME) received increased funding from last year’s levels, including a $151 million increase for the Health Resources and Services Administration (HRSA), a $1.25 billion increase for the National Institutes of Health, and a $19.5 million increase for HRSA's Title VII and Title VIII health professions workforce training programs.
The spending measure also extends a number of physician training programs through FY23, including the Teaching Health Center Graduate Medical Education Program, the National Health Service Corps, and community health centers. Relatedly, the bill includes several graduate medical education provisions to help alleviate the nation’s physician workforce shortage by providing additional funding slots to teaching hospitals, offering solutions to the so-called “resident rotator” problem, and easing rural training track requirements.
The COVID stimulus provides $22.7 billion for the Higher Education Emergency Relief Fund, directing $20.2 billion for public and private, non-profit institutions of higher education, including osteopathic medical schools, to be distributed by a formula taking into account head count and full-time equivalent enrollment. Moreover, the stimulus allows for $25.4 billion to support testing and contact tracing to effectively monitor and suppress COVID-19, with targeted funds to improve these efforts in high-risk and underserved populations. Healthcare professionals would receive $3 billion in reimbursements for healthcare expenses and financial losses in 2020 attributable to the virus.
Highlights of funding for programs and provisions of interest to OME are below.
- US Department of Education – $73.5 billion, an increase of $785 million
- Higher Education Funding – $2.5 billion for higher education programs, an increase of $66 million
- Free Application for Federal Student Aid (FAFSA) simplification and verification process to reduce the burden on students and institutions of higher education (IHEs), specifically providing support for students who, due to substance use disorders, are unable to include parental information in the FAFSA
- US Department of Health and Human Services – $97 billion, an increase of $2.1 billion
- National Institutes of Health (NIH) – $42.934 billion, an increase of $1.25 billion. The agreement provides a funding increase of no less than 1.5 percent above FY20 to every Institute and Center.
- Centers for Medicare and Medicaid Services – $4 billion for administrative expenses, level funding
- Medicare graduate medical education (GME) related provisions include:
- Supports physician workforce development by providing for the distribution of additional Medicare-funded GME residency positions. Rural hospitals, hospitals that are already above their Medicare cap for residency positions, hospitals in states with new medical schools, and hospitals that serve Health Professional Shortage Areas will be eligible for these new positions.
- Makes changes to Medicare GME Rural Training Tracks (RTT) to provide greater flexibility for rural and urban hospitals that participate in RTT programs.
- Allows hospitals to host a limited number of residents for short-term rotations without being negatively impacted by a set permanent full-time equivalent resident cap or a Per Resident Amount.
- Medicare graduate medical education (GME) related provisions include:
- Agency for Healthcare Research and Quality – $338 million, level funding
- National Health Service Corps – $120 million, level funding, extended at current levels for each of fiscal years 2021 through 2023
- Health Resources and Services Administration – $7.484 billion, an increase of $151 million
- Title VII and Title VIII Health Professions Workforce Training and Scholarship Programs – $754 million, an increase of $19.5 million
- Primary Care Training and Enhancement Programs – $48.9 million, level funding
- Geriatrics Programs – $42.737 million, a $2 million increase
- Behavioral Health Workforce Education and Training Program – $112 million, an increase of $10 million
- Public Health and Preventative Medicine – $17 million, level funding
- Teaching Health Center Graduate Medical Education (THCGME) Program – Extends mandatory funding for the THCGME Program at current levels for each of fiscal years 2021 through 2023.
- Rural health programs – $329.5 million, an increase of $11.2 million
- Health Careers Opportunity Program – $15 million, level funding
- Area Health Education Centers (AHECs) – $43.25 million, an increase of $2 million
- Includes $2 million for AHECs for new competitive grants to expand experiential learning opportunities through simulation labs designed to educate and train healthcare professionals serving rural, medically underserved communities, allowing for the purchase of simulation training equipment. HRSA is directed to consider and prioritize projects from AHEC recipients with a history of successfully graduating and placing graduates in rural, medically underserved communities.
- Centers of Excellence – $23.7 million, level funding
- Scholarships for Disadvantaged Students – $51.47 million, level funding
- $82 billion for the Education Stabilization Fund to support the educational needs of States, school districts, and IHEs and the students they serve in response to coronavirus
- $25.4 billion to support testing and contact tracing to effectively monitor and suppress COVID-19, as well as to reimburse for healthcare related expenses or lost revenue attributable to the coronavirus
- $22.7 billion for the Higher Education Emergency Relief Fund, directing $20.2 billion for public and private, non-profit IHEs, including osteopathic medical schools, to be distributed by a formula taking into account head count and full-time equivalent enrollment
- $8.75 billion for the Centers for Disease Control and Prevention to plan, prepare for, promote, distribute, administer, monitor, and track coronavirus vaccines to ensure broad-based distribution, access, and vaccine coverage
- $4.25 billion to provide increased mental health and substance abuse services and support
- $4.1 billion for the Governor’s Emergency Education Relief Fund
- $1.15 billion for NIH research and clinical trials related to long-term studies of COVID-19
Please contact AACOM Government Relations at aacomgr@aacom.org with questions or for further information.
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